Effectiveness of Bleomycin Infiltration in the Treatment of Keloids

Abstract

Aim: The aim of this study was to evaluate the efficacy of bleomycin in the treatment of keloids in phototype VI patients. Materials and Methods: We included patients aged over 16 years with keloids evolving between 12 and 24 months who had never been treated. Bleomycin was dissolved in 14 cc (10 cc of 0.9% isotonic saline and 4 cc of xylocaine). Using an insulin syringe, the product was administered every 15 days. Efficacy was assessed using the Patient-Observer Assessment Scale (POSAS) at d0, d30, d60 and d90. Results: We enrolled 31 patients and performed an average of 2.77 sessions. The observer's POSAS improved from 30.46 to 13.45. The patient's POSAS decreased from 36.95 to 13.48. All the POSAS parameters improved. In terms of tolerance, we observed side effects in 21 cases (67.7%). In the immediate short term, these were agitation in 1 case (3.2%) and hypotension in another (3.2). Only one patient (3.2%) experienced transient dizziness. In the medium and long term, skin necrosis was noted in 13 cases (41.9%), and peri-lesional hyperpigmentation in 6 cases (19.4%). One of our patients developed transient bilateral palmar hyperpigmentation. Conclusion: Bleomycin infiltration is effective in the treatment of keloids. Dissolution in 14cc of solution is indicated to prevent necrosis.